FR2977142A1 - DEVICE FOR THE INSTALLATION OF A DENTAL PROSTHESIS - Google Patents

Abstract

Implant bar (10; 10 ') for the fitting of a dental prosthesis, characterized in that it comprises at its upper surface (13; 13') at least one well (11; 11 ') intended for the insertion and housing of an implant (20; 20 '), the diameter of which is between 2.5 and 3 mm inclusive.

Description

The present invention relates to an implant bar for fitting a dental prosthesis and to a dental prosthesis fitting kit.

The treatment of the largely toothless people is delicate, relies today on a complex process and a non optimal tooling. The existing methods have indeed all or some of the following disadvantages - They use implants fixed in the bone structure, also called "bone mass", large diameter, greater than 3 mm, which requires several drilling operations with drills of diameter increasingly important to gradually form an opening in the bone mass of diameter corresponding to screw implants; - They require long and complex interventions, with an interruption to make a prosthesis in the course of intervention; - They offer bulky prostheses, including thick gums, which gives an unattractive and unrealistic result; - They are not adapted to the case of people whose volume of bone mass is greatly reduced.

The object of the invention is therefore to provide an improved solution for the installation of a dental prosthesis, which does not have all or some of the disadvantages mentioned above. More specifically, the invention seeks to achieve the following objects:

A first object of the invention is a solution for the installation of a dental prosthesis allowing the implementation of a simplified and accelerated laying method. A second object of the invention is a solution for laying a dental prosthesis. a dental prosthesis to achieve an attractive aesthetic result with a volume and shape close to reality.

For this purpose, the invention is based on an implant bar for fitting a dental prosthesis, characterized in that it comprises at its upper surface at least one well intended for insertion and housing of an implant. , whose diameter is between 2.5 and 3 mm inclusive.

The implant bar may comprise at least one well for insertion and housing of an implant, whose diameter is between 2.6 and 2.9 mm inclusive.

The implant bar may include at least one well for insertion and housing of an implant, whose diameter is between 2.7 and 2.8 mm inclusive.

All of its wells for insertion and accommodation of an implant may have a diameter of between 2.5 and 3 mm, or between 2.6 and 2.9 mm, or between 2.7 and 2.8 mm, inclusive .

The at least one well may have a direction substantially perpendicular to the upper surface of the implant bar.

The implant bar may include an abutment surface for an implant within a well.

A well may comprise an extension under its lower surface, capable of coming above the gum or on a bone mass. The implant bar may comprise at least one well having a threaded portion in a lower part to cooperate with a corresponding thread. an implant.

The implant bar may include an abutment surface for an implant within at least one of its wells, and its threaded portion may be below this abutment surface and / or under the lower surface of the implant bar.

The implant bar may comprise at least one opening of smaller diameter than that of the wells for the positioning of an osteosynthesis screw. For example, the diameter of an opening may be less than 2 mm, or less than 1.5 mm, or less than or equal to 1.3 mm.

The implant bar may comprise at least two wells or at least three wells and / or may comprise at least two openings or at least three openings.

The implant bar may comprise a square or rectangular or rounded section, interrupted by wells and / or substantially cylindrical openings.

The implant bar may be made of metallic material, and / or may comprise titanium and / or a titanium alloy. The invention also relates to a kit for fitting a dental prosthesis, characterized in that it comprises a guide and an implant bar as described above.

The guide may comprise openings in which the wells of the implant bar may be accommodated. The dental prosthesis installation kit may comprise all or part of the following additional components: implants with a diameter of between 2.5 and 3 mm, or between 2.6 and 2.9 mm, or between 2.7 and 2.8 mm, inclusive; and / or osteosynthesis screws with a diameter of less than 2 mm, or less than 1.5 mm, or less than or equal to 1.3 mm; and / or - pillars for attachment to an implant; and / or - a dental prosthesis.

The invention also relates to a computer medium readable by a management unit, characterized in that it comprises a registered computer program comprising computer program code means for implementing a method for manufacturing an implant bar. as previously described.

These objects, features and advantages of the present invention will be set forth in detail in the following description of particular embodiments given in a non-limiting manner in relation to the appended figures among which:

Figures 1a and 1b respectively represent jaw portions to be treated in two particular configurations chosen by way of example.

Figures 2a and 2b respectively show the jaw portions to be treated covered by a guide according to one embodiment of the invention.

Figs. 3a and 3b show respectively the jaw portions to be treated after gingival drilling using the guide. Figs. 4a and 4b show the guide and the implant bar in assembled configuration.

Figures 5a and 5b respectively show in perspective from above the guides used in the two particular configurations according to one embodiment of the invention.

Figures 6a and 6b respectively show in perspective from above the implant bars used in the two particular configurations according to one embodiment of the invention.

FIG. 7a shows a step of fixing an implant bar with the aid of osteosynthesis screws.

Figures 8a and 8b respectively show the implant bars after fixation in the two particular configurations.

Figures 9a and 9b respectively show the placement of implants through the implant bars in the two particular configurations. Figure 10b shows the installation of the prosthesis in the case of the second configuration envisaged.

FIG. 11 shows in side section at the level of an implant a phase of placement of an implant through an implant bar according to a first embodiment of the invention.

FIG. 12 shows in side section at the level of an implant an implant positioned within the bone mass of a jaw through an implant bar according to the first embodiment of the invention. FIG. on the side of an implant an implant and an osteosynthesis screw positioned within the bone mass of a jaw through an implant bar according to the first embodiment of the invention. Figure 14 shows an implant according to one embodiment of the invention.

FIG. 15 is a side section at an implant of an implant 10 positioned through an implant bar according to a second embodiment of the invention.

Figure 16 is a side section at an implant of implants and osteosynthesis screws positioned within the bone mass of a jaw through an implant bar according to the second embodiment of the invention.

Figure 17 shows an implant according to a second embodiment of the invention. The invention is based on a new treatment approach, and artificial dentition closer to reality, with a very acceptable aesthetic, suitable for easier implantation.

To fully understand this new approach, the processing implemented and the associated devices will be detailed, from two particular configurations of a jaw part: the first configuration, illustrated by the figures bearing the index a, concerns a lower jaw completely toothless, and the second configuration, illustrated by Figures 30 bearing the index b, represents a restricted portion of a lower jaw. Of course, the same principle can be implemented for any part of a jaw, inferior and / or superior, involving at least two or at least three implants. On the other hand, the vertical direction and the terms "high" and "low" will be used later in the reference of the teeth, in a direction oriented from the gum to the top of the teeth. Thus, the terms "high" and "upper" refer to the elements oriented towards the top of the teeth and the terms "low" and "lower" the elements oriented towards the gingiva.

FIGS. 1 a and 1 b thus schematically represent respectively a maxillary arch and a portion of the jaw to be treated, having lost their original teeth, comprising a bone mass 1 covered by a gingiva 2.

A first upstream phase of the treatment is based on the preparation of the future dental prosthesis, intended to replace the original teeth by reproducing at best their forms and mechanical characteristics, by a computer treatment based on a medical imaging method. Specifically, a scan of the jaw of the person concerned is performed to obtain an image of the jaw bone and any remaining teeth. Software processing is used to determine the most appropriate locations for implant placement in the jaw bone and dental prosthesis closest to the original dentition, in order to obtain the most accurate result possible and the best possible result. more adapted to the existing framework for a durable maintenance. This computer processing is done by any existing solution, the invention does not relate specifically to this upstream phase.

When this positioning is determined, a preliminary step to the treatment that will be described below consists of the manufacture of an implant bar 10 and a resin guide 3, which form the two basic components for implant placement, and a dental prosthesis 30.

A dental prosthesis installation kit is then formed and transmitted to an operator, comprising a guide and an implant bar. Alternatively, the dental prosthesis installation kit may further comprise all or part of the following components, which will be described in detail later, and which may also be distributed separately: implants, and / or screws osteosynthesis, and / or abutments for attachment to an implant, and / or a dental prosthesis.

The first step of the treatment is to position the resin guide 3 on the gum, as shown in Figures 2a and 2b, and to fix it by locking pins to obtain its maintenance. This guide includes openings 4 provided on its upper surface, which guide a first drilling operation of the gum 2 at the precise locations for the placement of implants and possibly screws osteosynthesis, as will be described later. This first bore performs a gingival cut that stops at the contact with the bone mass 1, so as to make corresponding openings 5 in the gingiva.

A second step consists of a removal of the guide, as can be seen in FIGS. 3a and 3b, and then the integration of the implant bar 10 inside the guide, on the side of its lower face, to form an assembly represented on Figures 4a and 4b. This assembly is then repositioned on the gum 2 on the area to be treated.

The guide 3 used is more precisely shown in perspective from above by Figures 5a and 5b for respectively the two particular configurations envisaged. It comprises a shape that conforms to the upper surface of the jaw, has a substantially semi-circular section, shaped inverted gutter. First circular openings 4 are provided, the diameter of which corresponds precisely to the drilling of the gingiva, as has been explained above, for the future positioning of implants. Second smaller openings 7 are intended for the passage of future osteosynthesis screws. In the first case of Figure 5a, the guide further comprises a slot 6 or groove which extends over the entire length at the central portion of the underside of the guide. This groove 6 is shown in transparency through the upper wall of the guide in certain figures. The guide is preferably resin, optionally comprises titanium tubes.

The implant bar 10 is more particularly illustrated by FIGS. 6a and 6b. It comprises a substantially rectangular or square section, or alternatively a different section, comprising for example rounded, forming an upper surface 13 and a lower surface 14 substantially horizontal, interrupted by cylindrical portions of substantially vertical axis, which we will simply call "Well" 11, for the housing of implants, as will be detailed later. The implant bar 10 further comprises second additional through openings 12, of smaller dimensions than the wells 11, which are similarly oriented substantially vertically, intended to receive retaining osteosynthesis screws, as explained below. The wells 11 comprise a lower portion 15 which extends below the lower surface 14 of the implant bar. Similarly, the openings 12 are extended by extensions 16 under the lower surface 14 of the implant bar. The implant bar finally forms an armature of the dental prosthesis and is preferably made of metallic material, advantageously comprises titanium and / or a titanium alloy.

In the second step of repositioning, the wells 11 of the implant bar 10 are housed in the openings 4 of the guide 3, by the lower face of the guide 3, and their lower extensions 15, as well as the extensions 16 of the openings 12, are housed all or part of the gingival cuts made in the previous step, so as to bear on the bone or to remain above the gum in two embodiments which will be detailed later. In addition, the second openings 12 of the implant bar 10 are likewise accessible through the openings 7 of the guide 3. Then, osteosynthesis screws 19 are positioned through the second openings 7 of the guide 3 and the second openings 12 of the guide. the implant bar 10, as shown in Figure 7a. The heads of these osteosynthesis screws 19 bear on the upper surface 13 of the bar and ensure its maintenance in the bone mass 1 of the person treated.

In a third step, the guide 3 is withdrawn in a substantially vertical direction, leaving the implant bar alone in position, as shown in FIGS. 8a and 8b. The implant bar 10 is now permanently fixed in place precisely on the jaw and sufficiently maintained for further processing which consists of the placement of the implants, as shown in Figures 9a and 9b. For this, drilling of the bone mass is performed through the wells 11 of the implant bar 10, and then the fixation of the implants 20 through the wells 11 of the implant bar is implemented. Note that the osteosynthesis screws 19 have the main function of maintaining the implant bar during this step of placing the implants 20. They can be stored or alternatively removed after the end of the operation.

The implants 20 have a greater diameter than the osteosynthesis screws 19 and a longer length, and their function is to ensure the maintenance of the prosthesis and its armature formed by the implant bar, during its daily use during which in particular, it is necessary to mechanically withstand the very large mechanical forces applied during chewing.

Finally, a fourth step consists in fixing the dental prosthesis 30 on the implant bar 10, to achieve the finished result visible for example in Figure 10b. This fixing can be done by a saddle with a suitable cement or screwing, or any other fixing solution.

Figures 11 to 14 illustrate different enlarged and sectional views of details of the components presented above, according to a first embodiment. FIG. 11 shows an intermediate phase of placing an implant 20 in the bone mass 1 through a well 11 of the implant bar 10. For this, the well 11 comprises an internal thread 17 compatible with the threading of the implant, which allows its screwing inside the well 11.

Figure 12 shows the implant 20 in the end position. It comprises a first lower portion 21 screwed into the bone mass 1, which will ensure a high performance of the entire host structure of the dental prosthesis, including a strengthening over time by osseointegration of the implant. A second, higher part 22 of the implant 20 comprises a second thread which remains in cooperation with the internal thread 17 of the implant bar in the well 11, the lower end of the lower extension 15 bears on the surface. 1 This second thread of the implant prevents any vertical movement of the implant bar 10, which remains in this same position, even if the bone mass 1 is degraded, for example with its aging. .

Note, in this illustrated embodiment, the implant 20 comprises a head 25 which comprises a lower surface forming a stop 26 bearing on a flat surface 18 arranged in the upper part of the well 11, which forms a corresponding stop. This stop ensures the correct positioning of the implant 20, the screwing must be continued to the stop, and ensures the maintenance of the implant bar 11 and in particular participates in preventing any upward movement. The head 25 of the implant 20 further comprises a hollow cylindrical portion 27 threaded at its upper end, oriented in a vertical direction, provided for fixing by screwing a prosthesis 30, as shown in Figure 13 .

Figure 14 illustrates more specifically an implant 20 used in this embodiment. Its first lower portion 21 comprises a first thread whose teeth have a triangular and / or trapezoidal section. More generally, this first thread may be of any type suitable for optimal compatibility with a bone structure since this first portion 21 is intended for screwing and integration into a bone structure. The second portion 22 of the implant 20, positioned between its head 25 and its first portion 21, comprises a second thread intended to cooperate with the threading of an implant bar 10. In this embodiment, it comprises section teeth. square. Note, an intermediate portion 23 between these two parts 21, 22 of the implant 20 comprises a progressive evolution of the thread from one section to another, and further includes teeth with micro-nets 24 to ensure the sealing of the teeth, useful since this intermediate portion 23 is intended for positioning between the gingiva 2 and the bone mass 1, as can be seen in FIG. 13. Generally, the first and second portions 21, 22 of the implant 20 are arranged on a cylindrical rod of constant diameter, corresponding to the diameter of a well 11 of the implant bar. The implant 20, however, includes a conical or pointed portion towards its lower end to facilitate its positioning in the jaw. Over all this threaded length, the implant 20 has a constant thread pitch since it integrally passes through the same thread of a well 11 of an implant bar 10.

The dimensioning of the implant represents a compromise between a reduced size to form a sufficiently discrete or even invisible reinforcement, compatible with the use of a dental prosthesis having a form close to reality and therefore an acceptable aesthetic, and between a size large enough to withstand the significant mechanical stresses they undergo. In contrast to the solutions adopted by the state of the art, the implant is advantageously chosen with a diameter of less than 3 mm, between 2.5 and 3 mm, and preferably between 2.6 and 2.9 mm, or even between 2.7 and 2.8 mm, these terminals being included. Note, all these diameters are measured in the constant section portion of the first or second parts of the implant. Advantageously, all the implants and all the corresponding wells of the implant bar will respect these ranges of values. The use of these implants, small diameters compared to the state of the art, also simplifies their installation by greatly reducing drilling operations in the bone mass. Indeed, these operations require the progressive use of several drills to reach the final diameter when it is large, which is long and tedious.

On the other hand, the implant may be of metal material, may be titanium or titanium alloy, include vanadium and / or titanium and / or chromium / cobalt, for example be TA6V. Its length is adapted to the relevant jaw configuration. For this, its second portion 22, intended to pass through the jaw 2, will generally have a length of between 1 and 5 mm, while the first portion 21 intended to be in the bone mass 1 will have a length of between 6 and 14 mm , and in general a length of between 8 and 12 mm inclusive, 8, 10 or 12 mm for example.

As a reminder, the osteosynthesis screws 19 fulfill a totally different function of an implant 20, of simple temporary retention during the treatment and the placement of the implants 20. They allow a maintenance that is much less resistant than that of an implant and are not more very useful when the operation is over. This is why they can be removed or left without any consequences on the subsequent use of the dental prosthesis. For this, they have a thread diameter much lower than that of an implant, less than 2 mm, or even less than 1.5 mm or even less than 1.3 mm. In addition, their total length is also less than that of an implant, as can be seen, for example, in FIG. 13.

The implant bar 10 used finally forms a metal frame which provides a connection between all the implants and the dental prosthesis. This implant bar therefore comprises wells 11 oriented in a vertical direction, perpendicular to the upper surface 13 of the implant bar 10, to receive the implants 20, as has been explained, and smaller openings 12, to receive the screws. osteosynthesis 19, in a vertical direction. The diameter of these openings corresponds to the diameters of the implants 20 and screws 19 specified above, that is to say that this diameter has the value of the diameter of the implant, increased to a minimum so as to allow the passage of the implant. Advantageously, the game will be minimal between a well and an implant and we can consider that their diameter is the same. We consider here the diameter of the well at its narrowest part, in contact with the part located under the head of the implant. Alternatively, the implant bar can be fixed during its installation by any means other than the osteosynthesis screws shown. According to another variant, the direction of the wells 11 and / or openings 12 is not quite vertical, but nevertheless remains close to the vertical, has an angle less than or equal to 5 degrees of the vertical direction. This angle is therefore measured relative to the direction perpendicular to the upper surface 13 of the implant bar, which has a square or rectangular section, as has been seen previously, or with respect to the direction perpendicular to a plane tangential to its surface higher if the latter is different, for example rounded. Wells and possible openings may naturally have different shapes from those shown, not to extend over such a long length, for example.

Figures 15 and 16 show a second embodiment in which an implant 20 ', more particularly illustrated in Figure 17, is in a slightly different form. Indeed, it comprises a lower portion 21 'for positioning in the bone structure, similar to that described above, and a second portion 22' of smooth surface, the head 25 'has a stop 26' resting on a surface 18 'corresponding to a well 11' of an implant bar 10 '. In this embodiment, the lower surface of the well 11 'remains above the gum 2, close to the latter. The implant 20 'is covered with a pillar 28', fixed to the head 25 'of the implant 20' by any means, and screwed into the upper part 11 'of the well, until it bears on the head 25 ', in particular on a surface 27' superimposed and parallel to the stop 26 '. This configuration also ensures the maintenance in the vertical direction of the implant bar 10 '. The latter has a slightly different shape than that used in the previous embodiment in that its wells 11 'do not have a threaded portion in their low extension 15' in contact with the implants 20 '. On the contrary, the extensions 16 'of the openings 12' which receive the osteosynthesis screws 19 'bear on the bone mass

Claims (17)

1. Implant bar (10; 10 "for the installation of a dental prosthesis, characterized in that it comprises at its upper surface (13; 13") at least one well (11; insertion and housing of an implant (20; 20 '), the diameter of which is between 2.5 and 3 mm inclusive. 2. Implant bar (10; 10 "according to the preceding claim, characterized in that it comprises at least one well (11; 11" for insertion and housing of an implant (20; 20 '), of which the diameter is between 2.6 and 2.9 mm inclusive. 3. Implant bar (10; 10 "according to the preceding claim, characterized in that it comprises at least one well (11; 11 ') for insertion and housing of an implant (20; 20'), whose diameter is between 2.7 and 2.8 mm inclusive. 4. Implant bar (10; 10 "according to one of the preceding claims, characterized in that all its wells (11; 11" for insertion and housing of an implant (20; 20 ") have a diameter between 2.5 and 3 mm, or between 2.6 and 2.9 mm, or between 2.7 and 2.8 mm, inclusive. 5. Implant bar (10; 10 "according to one of the preceding claims, characterized in that the at least one well (11; 11 ') has a direction substantially perpendicular to its upper surface (13; 13". 6. Implant bar (10; 10 "according to one of the preceding claims, characterized in that it comprises a surface (18; 18" forming a stop 30 for an implant (20; 20 ") within a well (11 11 '). Implant bar (10; 10 ') according to one of the preceding claims, characterized in that a well (11; 11') comprises an extension (15; 15 ') under its lower surface (14; 14'). , able to come above the gum (2) or on a bone mass (1). 8. Implant bar (10) according to one of the preceding claims, characterized in that it comprises at least one well (11) having a threaded portion (17) in a lower part to cooperate with a corresponding thread of an implant . 10 9. Implant bar (10) according to the preceding claim, characterized in that it comprises a surface (18) forming an abutment for an implant within at least one of its wells (11) and in that its threaded portion is located beneath this abutment surface (18) and / or under the lower surface (14) of the implant bar (10). 10. Implant bar (10; 10 ') according to one of the preceding claims, characterized in that it comprises at least one opening (12; 12') of smaller diameter than that of the wells for positioning a screw Osteosynthesis (19; 19 '). 11. Implant bar (10; 10 ') according to the preceding claim, characterized in that the diameter of an opening (12; 12') is less than 2 mm, or less than 1.5 mm, or less than or equal to 1.3 mm. 12. Implant bar (10; 10 ') according to one of the preceding claims, characterized in that it comprises at least two wells (11; 11') or at least three wells (11; 11 ') and / or it comprises at least two openings (12; 12 ') or at least three openings (12; 12'). 25 30 13. Implant bar (10; 10 ') according to one of the preceding claims, characterized in that it comprises a square or rectangular or rounded section interrupted by wells (11; 11') and / or by openings (12 12 ') substantially cylindrical. 14. Implant bar (10; 10 ') according to one of the preceding claims, characterized in that it is made of metallic material, and / or comprises titanium and / or a titanium alloy. 10 15. Kit for fitting a dental prosthesis, characterized in that it comprises a guide (3) comprising openings (4) arranged on its upper surface, for guiding a first operation of drilling a gingiva at the precise locations intended for implant placement, and an implant bar (10; 10 ') according to one of the preceding claims. 15 16. A kit for fitting a dental prosthesis according to the preceding claim, characterized in that the guide (3) comprises openings (4) in which the wells (11; 11 ') of the implant bar can be housed. 20 17. Kit for fitting a dental prosthesis according to claim 15 or 16, characterized in that it comprises all or part of the following additional components: - implants (20; 20 ') with a diameter of between 2.5 and 3 mm, or between 2.6 and 2.9 mm, or between 2.7 and 2.8 mm, inclusive; and / or osteosynthesis screws (19; 19 ') with a diameter of less than 2 mm, or less than 1.5 mm, or less than or equal to 1.3 mm; and / or - pillars for attachment to an implant; and / or - a dental prosthesis (30). 30